The burden of inflammatory bowel disease (IBD) is rising globally, with substantial variation in levels and trends of disease in different countries and regions. Understanding these geographical differences is crucial for formulating effective strategies for preventing and treating IBD. We report the prevalence, mortality, and overall burden of IBD in 195 countries and territories between 1990 and 2017, based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. We modelled mortality due to IBD using a standard Cause of Death Ensemble model including data mainly from vital registrations. To estimate the non-fatal burden, we used data presented in primary studies, hospital discharges, and claims data, and used DisMod-MR 2.1, a Bayesian meta-regression tool, to ensure consistency between measures. Mortality, prevalence, years of life lost (YLLs) due to premature death, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were estimated. All of the estimates were reported as numbers and rates per 100 000 population, with 95% uncertainty intervals (UI). In 2017, there were 6·8 million (95% UI 6·4-7·3) cases of IBD globally. The age-standardised prevalence rate increased from 79·5 (75·9-83·5) per 100 000 population in 1990 to 84·3 (79·2-89·9) per 100 000 population in 2017. The age-standardised death rate decreased from 0·61 (0·55-0·69) per 100 000 population in 1990 to 0·51 (0·42-0·54) per 100 000 population in 2017. At the GBD regional level, the highest age-standardised prevalence rate in 2017 occurred in high-income North America (422·0 [398·7-446·1] per 100 000) and the lowest age-standardised prevalence rates were observed in the Caribbean (6·7 [6·3-7·2] per 100 000 population). High Socio-demographic Index (SDI) locations had the highest age-standardised prevalence rate, while low SDI regions had the lowest age-standardised prevalence rate. At the national level, the USA had the highest age-standardised prevalence rate (464·5 [438·6-490·9] per 100 000 population), followed by the UK (449·6 [420·6-481·6] per 100 000). Vanuatu had the highest age-standardised death rate in 2017 (1·8 [0·8-3·2] per 100 000 population) and Singapore had the lowest (0·08 [0·06-0·14] per 100 000 population). The total YLDs attributed to IBD almost doubled over the study period, from 0·56 million (0·39-0·77) in 1990 to 1·02 million (0·71-1·38) in 2017. The age-standardised rate of DALYs decreased from 26·5 (21·0-33·0) per 100 000 population in 1990 to 23·2 (19·1-27·8) per 100 000 population in 2017. The prevalence of IBD increased substantially in many regions from 1990 to 2017, which might pose a substantial social and economic burden on governments and health systems in the coming years. Our findings can be useful for policy makers developing strategies to tackle IBD, including the education of specialised personnel to address the burden of this complex disease. Bill & Melinda Gates Foundation.

Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100 000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries. In 2017, cirrhosis caused more than 1·32 million (95% UI 1·27-1·45) deaths (440 000 [416 000-518 000; 33·3%] in females and 883 000 [838 000-967 000; 66·7%] in males) globally, compared with less than 899 000 (829 000-948 000) deaths in 1990. Deaths due to cirrhosis constituted 2·4% (2·3-2·6) of total deaths globally in 2017 compared with 1·9% (1·8-2·0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21·0 (19·2-22·3) per 100 000 population in 1990 to 16·5 (15·8-18·1) per 100 000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32·2 [25·8-38·6] deaths per 100 000 population in 2017), and the high-income super-region had the lowest (10·1 [9·8-10·5] deaths per 100 000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3·7 [3·3-4·0] per 100 000 in 2017) and highest in Egypt in all years since 1990 (103·3 [64·4-133·4] per 100 000 in 2017). There were 10·6 million (10·3-10·9) prevalent cases of decompensated cirrhosis and 112 million (107-119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the other four causes showed declines in age-standardised death rate. The age-standardised prevalence of compensated and decompensated cirrhosis due to NASH increased more than for any other cause of cirrhosis (by 33·2% for compensated cirrhosis and 54·8% for decompensated cirrhosis) over the study period. From 1990 to 2017, the number of prevalent cases more than doubled for compensated cirrhosis due to NASH and more than tripled for decompensated cirrhosis due to NASH. In 2017, age-standardised death and DALY rates were lower among countries and territories with higher SDI. Cirrhosis imposes a substantial health burden on many countries and this burden has increased at the global level since 1990, partly due to population growth and ageing. Although the age-standardised death and DALY rates of cirrhosis decreased from 1990 to 2017, numbers of deaths and DALYs and the proportion of all global deaths due to cirrhosis increased. Despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, they were still the main causes of cirrhosis burden worldwide, particularly in low-income countries. The impact of hepatitis B and C is expected to be attenuated and overtaken by that of NASH in the near future. Cost-effective interventions are required to continue the prevention and treatment of viral hepatitis, and to achieve early diagnosis and prevention of cirrhosis due to alcohol-related liver disease and NASH. Bill & Melinda Gates Foundation.

Proanthocyanidins are condensed tannins with various pharmacological properties. These phytochemicals are considered as 'offense and defense molecules because of their human health benefits. The validation of their diverse health aspects, namely, antioxidant, anticancer, antidiabetic, neuroprotective, and antimicrobial has earned them repute in thermochemistry. Proanthocyanidins are oligo- or polymers of monomeric flavan-3-ols produced as an end product of flavonoid biosynthetic pathway. Agricultural wastes and food processing wastes contain immense amount of proanthocyanidins, exploitation of which can be a sustainable source of dietary supplements and functional ingredients. The current review article discusses recent developments in the health promoting properties of proanthocyanidins and the associated hurdles.

Plant-derived functional foods are gaining considerable attention due to their safety and therapeutic potentials. Research on plant-based functional foods presents several challenges ranges from hypercholesterolemia to cancer prevention. In last decade, special attention has been paid to edible plants and especially their phytochemicals. Today, there is an increasing interest in their bioactivities provided by these phytochemicals. Polyphenols are the most numerous and widely distributed group of bioactive molecules. Polyphenols have two general classes, one is flavonoids and other is phenolic acids. Among these, flavonoids are further divided into flavones, flavononse, flavonols, flavanols, isoflavones, and phenolic acids are generally classified into hydroxybenzoic and hydroxycinnamic acids. Fruit peel is one of the dense sources for flavonoids and their content may vary from species to species and due to exposure of light. Polyphenols have wide range of molecules and different set of biological activities that are mainly attributed to their structure. Investigations have revealed that polyphenols play a key role to prevent various diseases, like hypercholesterolemia, hyperglycemia, hyperlipidemia, and cancer insurgence. The current review article summarizes the literature pertaining to polyphenols and its allied health benefits.

For thousands of years, plant has been widely applied in the medical area and is an important part of human diet. A high content of nutrients could be found in all kinds of plants, and the most outstanding group of nutrients that attracts scientists’ attention is the high level of phenolic compounds. Due to the relationship between high phenolic compound content and high antioxidant capacity, plant extracts are expected to become a potential treatment for oxidation stress diseases including diabetes and cancer. However, according to the instability of phenolic compounds to light and oxygen, there are certain difficulties in the extraction of such compounds. But after many years of development, the extraction technology of phenolic compounds has been quite stable, and the only problem is how to obtain high-quality extracts with high efficiency. To further enhance the value of plant extracts, concentration and separation methods are often applied, and when detailed analysis is required, characterization methods including HPLC and LC/GC–MS will be applied to evaluate the number and type of phenolic compounds. A series of antioxidant assays are widely performed in numerous studies to test the antioxidant capacity of the plant extracts, which is also an important basis for evaluating value of extracts. This paper intends to provide a view of a variety of methods used in plants’ phenolic compound extraction, separation, and characterization. Furthermore, this review presents the advantages and disadvantages of techniques involved in phenolic compound research and provides selected representative bibliographic examples.

Fruit peels have a diverse range of phytochemicals including carotenoids, vitamins, dietary fibres, and phenolic compounds, some with remarkable antioxidant properties. Nevertheless, the comprehensive screening and characterization of the complex array of phenolic compounds in different fruit peels is limited. This study aimed to determine the polyphenol content and their antioxidant potential in twenty different fruit peel samples in an ethanolic extraction, including their comprehensive characterization and quantification using the LC-MS/MS and HPLC. The obtained results showed that the mango peel exhibited the highest phenolic content for TPC (27.51 ± 0.63 mg GAE/g) and TFC (1.75 ± 0.08 mg QE/g), while the TTC (9.01 ± 0.20 mg CE/g) was slightly higher in the avocado peel than mango peel (8.99 ± 0.13 mg CE/g). In terms of antioxidant potential, the grapefruit peel had the highest radical scavenging capacities for the DPPH (9.17 ± 0.19 mg AAE/g), ABTS (10.79 ± 0.56 mg AAE/g), ferric reducing capacity in FRAP (9.22 ± 0.25 mg AA/g), and total antioxidant capacity, TAC (8.77 ± 0.34 mg AAE/g) compared to other fruit peel samples. The application of LC-ESI-QTOF-MS/MS tentatively identified and characterized a total of 176 phenolics, including phenolic acids (49), flavonoids (86), lignans (11), stilbene (5) and other polyphenols (25) in all twenty peel samples. From HPLC-PDA quantification, the mango peel sample showed significantly higher phenolic content, particularly for phenolic acids (gallic acid, 14.5 ± 0.4 mg/g) and flavonoids (quercetin, 11.9 ± 0.4 mg/g), as compared to other fruit peel samples. These results highlight the importance of fruit peels as a potential source of polyphenols. This study provides supportive information for the utilization of different phenolic rich fruit peels as ingredients in food, feed, and nutraceutical products.